Table of Contents
ISRN Hepatology
Volume 2013 (2013), Article ID 959474, 7 pages
Clinical Study

NT-proBNP Changes in Patients with Ascites during Large Volume Paracentesis

1Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
2Department of Medical Oncology, Westmead Hospital, Sydney, NSW 2145, Australia
3Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia
4Department of Gastroenterology & Hepatology, Westmead Hospital, Sydney, NSW 2145, Australia

Received 3 July 2013; Accepted 21 August 2013

Academic Editors: B. C. Fuchs, A. M. Rijken, and A. K. Singal

Copyright © 2013 Vi Nguyen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. N-terminal probrain natriuretic peptide (NT-proBNP) is a hormone involved in the regulation of cardiovascular homeostasis. Changes in serum NT-proBNP during large volume paracentesis (LVP) in patients with ascites have never before been examined. Aims. To determine if significant changes in serum NT-proBNP occur in patients undergoing LVP and the associated clinical correlates in patients with cirrhosis. Method. A total of 45 patients with ascites were prospectively recruited. Serum NT-proBNP, biochemistry, and haemodynamics were determined at baseline and at key time points during and after paracentesis. Results. 34 patients were analysed; 19 had ascites due to cirrhosis and 15 from malignancy. In those with cirrhosis, NT-proBNP decreased by 77.3 pg/mL at 2 L of drainage and 94.3 pg/mL at the end of paracentesis, compared with an increase of 10.5 pg/mL and 77.2 pg/mL in cancer patients at the same time points ( and ). Only congestive cardiac failure (CCF) was an independent predictor of significant NT-proBNP changes at the end of drainage in cirrhotic patients ( ). There were no significant changes in haemodynamics or renal biochemistry for either group. Conclusion. Significant reductions in serum NT-proBNP during LVP occur in patients with cirrhosis but not malignancy, and only comorbid CCF appeared to predict such changes.